2种调方法对后牙种植修复患者咬合平衡及咀嚼肌肌力的影响

Effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patient with implant restoration

目的:观察种植义齿修复患者应用2种不同调方式后,咬合平衡及咀嚼肌肌力的变化及其变化的相关联系,为种植修复的调提供依据。方法:筛选单侧后牙游离缺失患者20例,植入Ankylos种植体,随机分为A、B 2组。A组为原始调组,B组为咬合面降低组。分别在种植固定义齿调完成、修复后3个月、修复后6个月3个时间点,对其咬合情况及咀嚼肌肌电进行测量分析,获取咬合平衡指标和咀嚼肌平衡指标,应用SPSS18.0软件包对数据进行t检验,比较2组各指标间的变化及差异。结果:A、B 2组在修复后3个月,咬合平衡各指标的改变及咀嚼肌平衡指标的改变具有显著差异。修复后6个月,咬合平衡各指标的改变无显著差异,咀嚼肌平衡指标的改变差异显著。结论:后牙游离缺失种植修复患者,采用咬合面降低调法,能够达到接近对侧天然牙相似的咬合指标及咀嚼肌肌电指标。

PURPOSE： To compare the effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patients with dental implant restoration.METHODS： Twenty patients,each with a single edentulous posterior dentition with no distal dentition were selected,and divided into 2 groups.Patients in group A underwent original occlusion adjustment method and patients in group B underwent occlusal plane reduction technique.Ankylos implants were implanted in the edentulous space in each patient and restored with fixed prosthodontics single unit crown.Occlusion was adjusted in each restoration accordingly.Electromyograms were conducted to determine the effect of adjustment methods on occlusion and muscles of mastication 3 months and 6 months after initial restoration and adjustment.Data was collected and measurements for balanced occlusal measuring standards were obtained,including central occlusion force（COF）,asymmetry index of molar occlusal force（AMOF）.Balanced muscles of mastication measuring standards were also obtained including measurements from electromyogram for the muscles of mastication and the anterior bundle of the temporalis muscle at the mandibular rest position,average electromyogram measurements of the anterior bundle of the temporalis muscle at the intercuspal position（ICP）,Astot,masseter muscle asymmetry index,and anterior temporalis asymmetry index（ASTA）.Statistical analysis was performed using Student ＇s t test with SPSS 18.0 software package.RESULTS： Three months after occlusion adjustment,parameters of the original occlusion adjustment method were significantly different between group A and group B in balanced occlusal measuring standards and balanced muscles of mastication measuring standards.Six months after occlusion adjustment,parameters of the original occlusion adjustment methods were significantly different between group A and group B in balanced muscles of mastication measuring standards,but was no significant difference in balanced occlusal measuring standards.CONCLUSIONS： Using occlusion plane reduction adjustment technique,it is possible to obtain occlusion index and muscles of mastication ＇s electromyogram index similar to the opposite side＇s natural dentition in patients with single unit fix prosthodontics crown and single posterior edentulous dentition without distal dentitions.